Takeaway
- Plasma fetuin-A levels were higher in both the first and the second trimesters among women with gestational diabetes mellitus (GDM).
- Dynamic change in plasma fetuin-A levels was associated with changes in insulin resistance and β-cell function from the first to the second trimester, and associated with an increased risk of the development of GDM.
Why this matters
- Findings indicated that fetuin-A may be an important biomarker involved in the pathogenesis of GDM.
Study design
- A nested case-control study included 135 women with GDM (cases) and equal number of age- and gestational age-matched women with normal glucose tolerance (controls).
- All women were categorised into different quartiles (Q1, Q2, Q3 and Q4) according to the distribution of fetuin-A concentration.
- Funding: National Natural Science Foundation of China.
Key results
- GDM vs placebo group had a significantly higher plasma fetuin-A concentration during:
- first (medians, 403.0 vs 273.4 pg/mL) and
- second trimester (medians, 475.7 vs 290.8 pg/mL; P<.05 for both).
- In the multivariate analysis, change in fetuin-A concentration from the first to the second trimester was associated with changes in fasting insulin level (β, 0.032; P<.001), homoeostasis model assessment (HOMA) of insulin resistance (β, 0.007; P<.001) and HOMA of β-cell function (β, 0.426; P=.001).
- Compared with lowest quartile, highest quartile of the increase in fetuin-A concentration from the first to the second trimester was associated with a higher risk of developing GDM (OR, 2.14; 95% CI, 1.05-4.37; P=.002).
- The optimal cut-off value of fetuin-A levels during the first trimester as an indicator for diagnosing GDM was 305.9 pg/mL with a sensitivity of 0.644, specificity of 0.585 and with the area under curve at 0.612 (95% CI, 0.544-0.680).
Limitations
- Results have limited generalisability.
References
References
